OBES SURG DOI 10.1007/s11695-015-1597-7
ORIGINAL CONTRIBUTIONS
Laparoscopic Adjustable Gastric Banding (LAGB) Aftercare Attendance and Attrition Lisa S. Hochberg & Kylie D. Murphy & Paul E. O’Brien & Leah Brennan
# Springer Science+Business Media New York 2015
Abstract Background Regular aftercare attendance following laparoscopic adjustable gastric banding (LAGB) is associated with greater weight loss and fewer post-surgical complications. Despite high reported rates of attrition from LAGB aftercare, the reasons for non-attendance have not been previously explored. The present study aimed to explore patient-reported barriers to LAGB aftercare attendance, and the perceived helpfulness of potential attrition-reducing strategies, in both regular attendees and non-attendees of aftercare. Methods One hundred and seventy-nine participants (107 regular attendees and 72 non-attendees) completed a semistructured questionnaire, assessing barriers to attrition (101 items) and usefulness of attrition prevention strategies (14 items). Results Findings indicate that both regular attendees and nonattendees experience multiple barriers to aftercare attendance. Non-attendees generally reported that barriers had a greater impact on their aftercare attendance. There was evidence for L. S. Hochberg : K. D. Murphy : P. E. O’Brien : L. Brennan Centre for Obesity Research and Education, Monash University, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne 3004, Australia L. S. Hochberg e-mail: [email protected] K. D. Murphy e-mail: [email protected] P. E. O’Brien e-mail: [email protected] L. S. Hochberg School of Psychology, Monash University, Wellington Road, Clayton, VIC 3168, Australia K. D. Murphy : L. Brennan (*) School of Psychology, Australian Catholic University, Locked Bag 4115, Melbourne, VIC 3065, Australia e-mail: [email protected]
some level of acceptability for attrition-reducing strategies suggesting that LAGB patients may be receptive to such strategies. Conclusions Current findings highlight the importance of assessing barriers to treatment in both attendees and non-attendees. It is proposed that addressing barriers that differentiate non-attendees from attendees may be most effective in reducing attrition from aftercare. Keywords LAGB . Aftercare . Attrition . Perceived barriers . Facilitators . Strategies . Compliance . Attendance . Complications . Follow-up . Systematic review
Laparoscopic adjustable gastric banding (LAGB) results in safe, substantial and durable weight loss [1]. However, maximum success following LAGB surgery requires continual lifelong aftercare. This is essential for band adjustments [2, 3], weight and dietary assessments, patient education and diagnosis of complications [4–7]. Although all patients are encouraged to regularly attend LAGB aftercare, non-attendance is common, with reported attrition rates ranging from 15 % [3, 7] to more than 45 % [8]. Failure to attend aftercare has been associated with the development of post-operative complications, poorer weight loss and maintenance and inferior resolution of obesity related co-morbidities [5, 6, 8, 9]. However, little is known about the facilitators and barriers to LAGB aftercare attendance [10]. A comprehensive assessment of aftercare attrition is essential to identify modifiable attrition risk factors and potential strategies to enhance attendance and maximise the benefits of LAGB. Previous research assessing factors related to attrition from bariatric aftercare has not yielded consistent findings. A recent systematic review exploring predictors of attrition following bariatric surgery identified only eight studies addressing factors associated with aftercare attendance. Only four of these studies
OBES SURG
evaluated LAGB exclusively [10], and only two considered psychological constructs. The first found that depression, emotional eating and traumatic childhood were associated with attrition [5]. The second found that only narcissistic personality was negatively associated with the attendance [9]. The other two LAGB studies considered the impact of travel distance to the clinic. Greater travel distance was associated with fewer follow-up visits in one study [8] and was not associated with aftercare attendance in the other [11]. No other factors associated with LAGB aftercare attendance were considered. The limited and inconsistent findings of these studies do not provide a thorough understanding of LAGB aftercare attrition. The majority of research examining attrition across the nonsurgical weight loss literature has assessed pre-treatment predictors of attrition [12]. Few consistent findings have emerged. For example, patient demographics including gender [13, 14], age [15–17] and initial BMI [13, 18] have demonstrated an association with attrition in several weight loss studies, but not in others [19–21]. A recent systematic review of predictors of weight loss intervention attrition concluded that most demographic variables do not consistently predict attrition [22]. The review highlighted that patient psychological (e.g. high treatment expectations, motivation) behavioural (e.g. more previous weight loss attempts) and practical issues (e.g. travel distance) were more commonly associated with attrition than other baseline or pre-treatment variables (e.g. ethnicity) [22]. Findings were, however, inconsistent across studies with several psychological and behavioural variables demonstrating both negative and positive associations with attrition. A less commonly used assessment approach involves contacting participants who discontinue treatment to obtain their reasons for treatment discontinuation [12, 23, 24]. This method allows for the evaluation of participants’ perspectives on the barriers that lead to their attrition and consideration of problems previously not anticipated by researchers [25]. This approach has identified practical barriers including lack of time, logistics and work commitments as the primary reasons for attrition from weight loss interventions [26–29]. Other perceived barriers to attendance have included lack of treatment motivation [30–32], lack of treatment efficacy [33–35], factors associated with the treatment approach [29, 36], treatment being too demanding [37], health-related problems [32, 38] and dissatisfaction or issues with the treating clinician [12, 18]. Few weight loss studies [12, 24] have comprehensively and systematically considered patient-reported reasons for attrition. None have examined this in a post-bariatric patient population. One of the few studies to methodically assess weight loss treatment attrition utilised a structured telephone questionnaire to assess reasons for attrition. Practical difficulties accounted for almost half of the primary reasons for attrition, followed by unsatisfactory results (i.e. not achieving weight loss goals) and lack of motivation [24]. Additionally, a
number of participants reported that attrition was motivated by satisfaction with treatment results [24]. However, this study did not ask treatment completers about their barriers to participation. Consequently, it is not known whether those who completed treatment experienced fewer barriers or experienced similar barriers yet were able to overcome them. The one study to examine barriers to weight loss treatment in both treatment completers and non-completers assessed adolescents and their parents participating in a family-based cognitive behavioural lifestyle intervention [12]. While both completers and non-completers experienced barriers to participation, those who discontinued treatment reported experiencing significantly more treatment barriers [12]. There is a need for research to explore this further in order to determine which barriers discriminate dropouts and which are experienced by both completers and non-completers. There is an absence of research examining strategies to reduce attrition from bariatric surgical aftercare. Various strategies have successfully reduced attrition in non-surgical weight loss interventions. Strategies have included flexible treatment schedules [39, 40], providing convenient treatment locations [41] and treatment follow-up/reminder phone calls [42], altering the duration/intensity of treatment [43, 44], making treatment more culturally sensitive [45, 46], modifying the delivery mode of treatment [47, 48], support groups [49, 50], bringing a friend to treatment [51], group rather than individual treatment [52], providing incentives and rewards [53–55], including motivational programmes [56], using motivational interviewing techniques [57–59] and targeting weight loss expectations [39]. Interventions perceived as helpful by consumers are more likely to be sought out, implemented, adhered to and maintained [60–65]. Thus, evaluating patientperceived helpfulness of these strategies in reducing LAGB aftercare attrition will inform future intervention efforts. The present study aimed to explore patient-reported barriers to LAGB aftercare attendance and attitudes to potential attrition-reducing strategies. The primary aims were to identify which barriers made attending LAGB aftercare most difficult for both attendees and non-attendees and to evaluate if there was a difference in attendee- and non-attendee-reported barriers to attendance. The secondary aim of the study was to initiate exploratory analyses of the perceived helpfulness of strategies aimed at reducing LAGB aftercare attrition.
Method Participants The sample comprised of 179 (female n=134, male n=45; M=49.10 years, SD=10.18 years) LAGB patients from a Melbourne (Australia) bariatric surgery clinic. Inclusion criteria were the following: (i) 18–70 years of age and (ii)
OBES SURG
having a LAGB procedure at the Centre for Bariatric Surgery (CBS) between 2005 and 2010. Participants were excluded from the study if in the past 12 months they had (i) accessed LAGB aftercare from another service; (ii) experienced childbirth, a major illness, major surgery; (iii) experienced a long hospital stay (>2 weeks); (iv) lived, or were currently living, interstate/overseas or (v) had their gastric band removed. Patients entered the aftercare programme following standard placement of a LAGB (Lap-Band system, Inamed Health, Santa Barbara, California) by an experienced surgeon. Patients generally had their first visit 4 weeks after LAGB surgery and were encouraged to attend the clinic approximately every 4 weeks until an adequate level of restriction was reached. Patients were then encouraged to attend every 4 to 8 weeks during the first year and as required in subsequent years. Of note, the Centre for Bariatric Surgery does not charge an out-of-pocket fee for aftercare visits. Two non-randomised groups were included in the study. Attendees were defined as patients who had attended between three and five LAGB surgical aftercare sessions in the past 12 months (n=107). Non-attendees were defined as patients who had not attended any LAGB surgical aftercare sessions in the past 12 months (n=72). Materials Pre-surgical clinical data including age, operation age, baseline weight, baseline BMI, baseline excess weight and ideal weight was obtained from electronic medical records. A semi-structured questionnaire was designed for the purpose of the present study to assess the perceived barriers to attending LAGB aftercare and the perceived helpfulness of strategies to support attendance. The scale was developed as per scale development guidelines [66, 67]. A large item pool was generated from a pre-existing survey used to assess obesity intervention attrition [12]: the theoretical and empirical attrition literature (e.g. [10, 22]) and qualitative research [10]. A panel of 26 expert clinicians and researchers assisted with the initial generation of the item pool and the final item review. This provides support for the face and content validity of the scale [66, 67]. The questionnaire comprised a list of 101 commonly perceived barriers to aftercare attendance (e.g. you had feelings of failure) and 14 potential attrition-reducing strategies (e.g. reminders to schedule appointments). Barriers were grouped into ten themes derived from the literature including: treatment approach, motivation, expectations, mental health, success, clinician-related factors, behavioural factors, practical barriers, physical health, and social/family support (Table 1). Participants were required to rate on a five-point Likert scale (0=‘not at all’ to 4=‘completely’), (i) how much each barrier made it difficult for them to attend aftercare and (ii) how much they perceived the strategy would help them to attend
aftercare. The average score of items from each barrier theme was calculated to provide a theme score. All themes have acceptable internal consistency (α=0.71 to 0.94) providing evidence of reliability. None of the potential attritionreducing strategies had been used by the clinic from which participants were recruited (note that while text message reminders are sent by the clinic the day before an appointment the patient has already booked, they are not used in an attempt to reduce aftercare attrition by prompting the patient to schedule an appointment). Research Procedure Ethics approval for this study was granted by Monash University Human Research Ethics Committee. Eligible patients were identified by clinic staff and forwarded an explanatory statement outlining the nature and purpose of the study and an opt-out consent form. Patients were instructed to return the opt-out form if they did not wish to be contacted regarding participation in the study. Those who did not return the opt-out consent form were contacted by the researchers via phone. Two phone call attempts were made to contact participants. Patients who could be contacted within the study timelines (August through September 2012) were invited to take part in a 30-min telephone questionnaire. Verbal consent to participate was obtained prior to commencement of the questionnaire. The telephone questionnaire was administered by two interviewers trained and supervised to conduct the phone call by experienced clinical and health psychologists. Relevant clinical data (e.g. baseline BMI and weight) were obtained from the medical records of those who consented to participate.
Results The flow of participants through the study is outlined in Fig. 1. One hundred and seventy-nine (20.72 %) of the 864 potentially eligible patients, who were sent an explanatory statement and invited to participate in the study, completed the questionnaire Fig. 1. Sample Characteristics Descriptive statistics are reported for the overall sample and for attendees and non-attendees separately (see Table 1). Baseline weight, BMI, and excess weight, as well as self-reported current weight and BMI were significantly higher for non-attendees than for attendees. Percentage of excess weight loss (%EWL) was significantly higher for attendees than for non-attendees. The groups did not differ significantly in terms of gender, current age, operation age, ideal weight, weight or BMI loss.
OBES SURG Table 1
Total sample characteristics and comparisons of mean (SD) characteristics for attendee and non-attendee groups
Characteristic
Surgical Age (years) Weight (kg) BMI Excess weight (kg) Ideal weight Survey Age (years) Weight (kg)a BMIa Weight losta BMI change a %EWLa
Total (n=177) M (SD)
Attendees (n=107) M (SD)
Non-attendees (n=70) M (SD)
Independent sample t test
44.85 (10.05) 122.05 (25.41) 43.05 (7.78) 51.18 (22.70) 70.87 (7.33)
44.76 (10.53) 116.90 (23.32) 41.53 (7.28) 46.54 (20.78) 70.36 (6.94)
45.14 (9.25) 129.47 (26.92) 45.37 (8.09) 58.08 (24.14) 71.39 (7.72)
t(175)=−0.24, p=0.808 t(175)=−3.30, p=0.001 t(175)=−3.28, p=0.001 t(175)=−3.39, p=0.001 t(175)=−0.92, p=0.357
49.10 (10.18) 99.66 (23.80)
48.77 (10.79) 93.74 (21.58)
49.71 (9.16) 108.71 (24.32)
t(175)=−0.61, p=0.545 t(175)=−4.29, p
ORIGINAL CONTRIBUTIONS
Laparoscopic Adjustable Gastric Banding (LAGB) Aftercare Attendance and Attrition Lisa S. Hochberg & Kylie D. Murphy & Paul E. O’Brien & Leah Brennan
# Springer Science+Business Media New York 2015
Abstract Background Regular aftercare attendance following laparoscopic adjustable gastric banding (LAGB) is associated with greater weight loss and fewer post-surgical complications. Despite high reported rates of attrition from LAGB aftercare, the reasons for non-attendance have not been previously explored. The present study aimed to explore patient-reported barriers to LAGB aftercare attendance, and the perceived helpfulness of potential attrition-reducing strategies, in both regular attendees and non-attendees of aftercare. Methods One hundred and seventy-nine participants (107 regular attendees and 72 non-attendees) completed a semistructured questionnaire, assessing barriers to attrition (101 items) and usefulness of attrition prevention strategies (14 items). Results Findings indicate that both regular attendees and nonattendees experience multiple barriers to aftercare attendance. Non-attendees generally reported that barriers had a greater impact on their aftercare attendance. There was evidence for L. S. Hochberg : K. D. Murphy : P. E. O’Brien : L. Brennan Centre for Obesity Research and Education, Monash University, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne 3004, Australia L. S. Hochberg e-mail: [email protected] K. D. Murphy e-mail: [email protected] P. E. O’Brien e-mail: [email protected] L. S. Hochberg School of Psychology, Monash University, Wellington Road, Clayton, VIC 3168, Australia K. D. Murphy : L. Brennan (*) School of Psychology, Australian Catholic University, Locked Bag 4115, Melbourne, VIC 3065, Australia e-mail: [email protected]
some level of acceptability for attrition-reducing strategies suggesting that LAGB patients may be receptive to such strategies. Conclusions Current findings highlight the importance of assessing barriers to treatment in both attendees and non-attendees. It is proposed that addressing barriers that differentiate non-attendees from attendees may be most effective in reducing attrition from aftercare. Keywords LAGB . Aftercare . Attrition . Perceived barriers . Facilitators . Strategies . Compliance . Attendance . Complications . Follow-up . Systematic review
Laparoscopic adjustable gastric banding (LAGB) results in safe, substantial and durable weight loss [1]. However, maximum success following LAGB surgery requires continual lifelong aftercare. This is essential for band adjustments [2, 3], weight and dietary assessments, patient education and diagnosis of complications [4–7]. Although all patients are encouraged to regularly attend LAGB aftercare, non-attendance is common, with reported attrition rates ranging from 15 % [3, 7] to more than 45 % [8]. Failure to attend aftercare has been associated with the development of post-operative complications, poorer weight loss and maintenance and inferior resolution of obesity related co-morbidities [5, 6, 8, 9]. However, little is known about the facilitators and barriers to LAGB aftercare attendance [10]. A comprehensive assessment of aftercare attrition is essential to identify modifiable attrition risk factors and potential strategies to enhance attendance and maximise the benefits of LAGB. Previous research assessing factors related to attrition from bariatric aftercare has not yielded consistent findings. A recent systematic review exploring predictors of attrition following bariatric surgery identified only eight studies addressing factors associated with aftercare attendance. Only four of these studies
OBES SURG
evaluated LAGB exclusively [10], and only two considered psychological constructs. The first found that depression, emotional eating and traumatic childhood were associated with attrition [5]. The second found that only narcissistic personality was negatively associated with the attendance [9]. The other two LAGB studies considered the impact of travel distance to the clinic. Greater travel distance was associated with fewer follow-up visits in one study [8] and was not associated with aftercare attendance in the other [11]. No other factors associated with LAGB aftercare attendance were considered. The limited and inconsistent findings of these studies do not provide a thorough understanding of LAGB aftercare attrition. The majority of research examining attrition across the nonsurgical weight loss literature has assessed pre-treatment predictors of attrition [12]. Few consistent findings have emerged. For example, patient demographics including gender [13, 14], age [15–17] and initial BMI [13, 18] have demonstrated an association with attrition in several weight loss studies, but not in others [19–21]. A recent systematic review of predictors of weight loss intervention attrition concluded that most demographic variables do not consistently predict attrition [22]. The review highlighted that patient psychological (e.g. high treatment expectations, motivation) behavioural (e.g. more previous weight loss attempts) and practical issues (e.g. travel distance) were more commonly associated with attrition than other baseline or pre-treatment variables (e.g. ethnicity) [22]. Findings were, however, inconsistent across studies with several psychological and behavioural variables demonstrating both negative and positive associations with attrition. A less commonly used assessment approach involves contacting participants who discontinue treatment to obtain their reasons for treatment discontinuation [12, 23, 24]. This method allows for the evaluation of participants’ perspectives on the barriers that lead to their attrition and consideration of problems previously not anticipated by researchers [25]. This approach has identified practical barriers including lack of time, logistics and work commitments as the primary reasons for attrition from weight loss interventions [26–29]. Other perceived barriers to attendance have included lack of treatment motivation [30–32], lack of treatment efficacy [33–35], factors associated with the treatment approach [29, 36], treatment being too demanding [37], health-related problems [32, 38] and dissatisfaction or issues with the treating clinician [12, 18]. Few weight loss studies [12, 24] have comprehensively and systematically considered patient-reported reasons for attrition. None have examined this in a post-bariatric patient population. One of the few studies to methodically assess weight loss treatment attrition utilised a structured telephone questionnaire to assess reasons for attrition. Practical difficulties accounted for almost half of the primary reasons for attrition, followed by unsatisfactory results (i.e. not achieving weight loss goals) and lack of motivation [24]. Additionally, a
number of participants reported that attrition was motivated by satisfaction with treatment results [24]. However, this study did not ask treatment completers about their barriers to participation. Consequently, it is not known whether those who completed treatment experienced fewer barriers or experienced similar barriers yet were able to overcome them. The one study to examine barriers to weight loss treatment in both treatment completers and non-completers assessed adolescents and their parents participating in a family-based cognitive behavioural lifestyle intervention [12]. While both completers and non-completers experienced barriers to participation, those who discontinued treatment reported experiencing significantly more treatment barriers [12]. There is a need for research to explore this further in order to determine which barriers discriminate dropouts and which are experienced by both completers and non-completers. There is an absence of research examining strategies to reduce attrition from bariatric surgical aftercare. Various strategies have successfully reduced attrition in non-surgical weight loss interventions. Strategies have included flexible treatment schedules [39, 40], providing convenient treatment locations [41] and treatment follow-up/reminder phone calls [42], altering the duration/intensity of treatment [43, 44], making treatment more culturally sensitive [45, 46], modifying the delivery mode of treatment [47, 48], support groups [49, 50], bringing a friend to treatment [51], group rather than individual treatment [52], providing incentives and rewards [53–55], including motivational programmes [56], using motivational interviewing techniques [57–59] and targeting weight loss expectations [39]. Interventions perceived as helpful by consumers are more likely to be sought out, implemented, adhered to and maintained [60–65]. Thus, evaluating patientperceived helpfulness of these strategies in reducing LAGB aftercare attrition will inform future intervention efforts. The present study aimed to explore patient-reported barriers to LAGB aftercare attendance and attitudes to potential attrition-reducing strategies. The primary aims were to identify which barriers made attending LAGB aftercare most difficult for both attendees and non-attendees and to evaluate if there was a difference in attendee- and non-attendee-reported barriers to attendance. The secondary aim of the study was to initiate exploratory analyses of the perceived helpfulness of strategies aimed at reducing LAGB aftercare attrition.
Method Participants The sample comprised of 179 (female n=134, male n=45; M=49.10 years, SD=10.18 years) LAGB patients from a Melbourne (Australia) bariatric surgery clinic. Inclusion criteria were the following: (i) 18–70 years of age and (ii)
OBES SURG
having a LAGB procedure at the Centre for Bariatric Surgery (CBS) between 2005 and 2010. Participants were excluded from the study if in the past 12 months they had (i) accessed LAGB aftercare from another service; (ii) experienced childbirth, a major illness, major surgery; (iii) experienced a long hospital stay (>2 weeks); (iv) lived, or were currently living, interstate/overseas or (v) had their gastric band removed. Patients entered the aftercare programme following standard placement of a LAGB (Lap-Band system, Inamed Health, Santa Barbara, California) by an experienced surgeon. Patients generally had their first visit 4 weeks after LAGB surgery and were encouraged to attend the clinic approximately every 4 weeks until an adequate level of restriction was reached. Patients were then encouraged to attend every 4 to 8 weeks during the first year and as required in subsequent years. Of note, the Centre for Bariatric Surgery does not charge an out-of-pocket fee for aftercare visits. Two non-randomised groups were included in the study. Attendees were defined as patients who had attended between three and five LAGB surgical aftercare sessions in the past 12 months (n=107). Non-attendees were defined as patients who had not attended any LAGB surgical aftercare sessions in the past 12 months (n=72). Materials Pre-surgical clinical data including age, operation age, baseline weight, baseline BMI, baseline excess weight and ideal weight was obtained from electronic medical records. A semi-structured questionnaire was designed for the purpose of the present study to assess the perceived barriers to attending LAGB aftercare and the perceived helpfulness of strategies to support attendance. The scale was developed as per scale development guidelines [66, 67]. A large item pool was generated from a pre-existing survey used to assess obesity intervention attrition [12]: the theoretical and empirical attrition literature (e.g. [10, 22]) and qualitative research [10]. A panel of 26 expert clinicians and researchers assisted with the initial generation of the item pool and the final item review. This provides support for the face and content validity of the scale [66, 67]. The questionnaire comprised a list of 101 commonly perceived barriers to aftercare attendance (e.g. you had feelings of failure) and 14 potential attrition-reducing strategies (e.g. reminders to schedule appointments). Barriers were grouped into ten themes derived from the literature including: treatment approach, motivation, expectations, mental health, success, clinician-related factors, behavioural factors, practical barriers, physical health, and social/family support (Table 1). Participants were required to rate on a five-point Likert scale (0=‘not at all’ to 4=‘completely’), (i) how much each barrier made it difficult for them to attend aftercare and (ii) how much they perceived the strategy would help them to attend
aftercare. The average score of items from each barrier theme was calculated to provide a theme score. All themes have acceptable internal consistency (α=0.71 to 0.94) providing evidence of reliability. None of the potential attritionreducing strategies had been used by the clinic from which participants were recruited (note that while text message reminders are sent by the clinic the day before an appointment the patient has already booked, they are not used in an attempt to reduce aftercare attrition by prompting the patient to schedule an appointment). Research Procedure Ethics approval for this study was granted by Monash University Human Research Ethics Committee. Eligible patients were identified by clinic staff and forwarded an explanatory statement outlining the nature and purpose of the study and an opt-out consent form. Patients were instructed to return the opt-out form if they did not wish to be contacted regarding participation in the study. Those who did not return the opt-out consent form were contacted by the researchers via phone. Two phone call attempts were made to contact participants. Patients who could be contacted within the study timelines (August through September 2012) were invited to take part in a 30-min telephone questionnaire. Verbal consent to participate was obtained prior to commencement of the questionnaire. The telephone questionnaire was administered by two interviewers trained and supervised to conduct the phone call by experienced clinical and health psychologists. Relevant clinical data (e.g. baseline BMI and weight) were obtained from the medical records of those who consented to participate.
Results The flow of participants through the study is outlined in Fig. 1. One hundred and seventy-nine (20.72 %) of the 864 potentially eligible patients, who were sent an explanatory statement and invited to participate in the study, completed the questionnaire Fig. 1. Sample Characteristics Descriptive statistics are reported for the overall sample and for attendees and non-attendees separately (see Table 1). Baseline weight, BMI, and excess weight, as well as self-reported current weight and BMI were significantly higher for non-attendees than for attendees. Percentage of excess weight loss (%EWL) was significantly higher for attendees than for non-attendees. The groups did not differ significantly in terms of gender, current age, operation age, ideal weight, weight or BMI loss.
OBES SURG Table 1
Total sample characteristics and comparisons of mean (SD) characteristics for attendee and non-attendee groups
Characteristic
Surgical Age (years) Weight (kg) BMI Excess weight (kg) Ideal weight Survey Age (years) Weight (kg)a BMIa Weight losta BMI change a %EWLa
Total (n=177) M (SD)
Attendees (n=107) M (SD)
Non-attendees (n=70) M (SD)
Independent sample t test
44.85 (10.05) 122.05 (25.41) 43.05 (7.78) 51.18 (22.70) 70.87 (7.33)
44.76 (10.53) 116.90 (23.32) 41.53 (7.28) 46.54 (20.78) 70.36 (6.94)
45.14 (9.25) 129.47 (26.92) 45.37 (8.09) 58.08 (24.14) 71.39 (7.72)
t(175)=−0.24, p=0.808 t(175)=−3.30, p=0.001 t(175)=−3.28, p=0.001 t(175)=−3.39, p=0.001 t(175)=−0.92, p=0.357
49.10 (10.18) 99.66 (23.80)
48.77 (10.79) 93.74 (21.58)
49.71 (9.16) 108.71 (24.32)
t(175)=−0.61, p=0.545 t(175)=−4.29, p
